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Thyroid & Adrenal

How TCM Balances the HPT–HPA Axis to Restore Energy, Mood, and Metabolism

The thyroid (HPT axis) and the adrenals (HPA axis) are deeply interconnected. Stress hormones (cortisol) and thyroid hormones influence each other’s production, conversion, and cellular action, so addressing one without the other often misses the root. [12, 13]

How Common Are Thyroid & Adrenal Problems?

In the United States, 12% of people will develop a thyroid condition in their lifetime; an estimated 20 million Americans are affected today, and many are undiagnosed. [1] Hypothyroidism has been estimated around 4.6% of the U.S. population; hyperthyroidism around 1.2% [2–4]

Primary adrenal insufficiency (Addison’s disease) is rare (roughly 40–140 per million), but has been increasing in recent decades; secondary/tertiary forms also occur. [7, 6, 8] While true adrenal failure is uncommon, chronic stress is widespread and biologically meaningful for the HPA axis: in 2023–2024 surveys, 49% of U.S. adults reported frequent stress, and health, work, and money were leading sources. [9, 10]

Why We Treat Thyroid & Adrenals Together

Cortisol (the end-hormone of the HPA axis) can suppress pituitary TSH release and alter peripheral thyroid hormone conversion, typically reducing T3 and increasing reverse T3 during illness or high stress (“non-thyroidal illness syndrome”). That is one reason stress, sleep loss, illness, and overtraining can make thyroid symptoms fluctuate. [12, 13]

Clinical cross-talk highlights

  • Glucocorticoids (e.g., dexamethasone) lower TSH in humans; lowering cortisol can raise TSH. [11]
  • Critical illness/stress patterns often show ↓T3, normal/↓T4, ↑rT3, and normal/↓TSH. [13]
  • In Cushing’s (chronic cortisol excess), TSH suppression and reduced T4→T3 conversion are described. [14]

TCM Treatment Principles

In Traditional Chinese Medicine we assess patterns, not isolated lab values. Because HPT and HPA physiology map closely to the Brain, Spleen, Kidney and Liver network in TCM, we emphasize harmonizing these systems while relieving symptoms. Acupuncture has emerging evidence in Hashimoto’s thyroiditis for improving antibodies and thyroid indicesthough study quality varies and individualized diagnosis remains key. [15–18]

Acupuncture Treatment

We select points to regulate the Spleen/Kidney axis, soothe the Liver, calm the Shen, and promote local thyroid blood flow/microcirculation. Meta-analytic evidence suggests acupuncture can reduce TPOAb/TGAb and improve FT3/FT4/TSH in Hashimoto’s compared with medication alone (more high-quality RCTs are needed). [18]

Neuroendocrine Acupuncture (Xing Nao Kai Qiao) Focus on the CNS-Hypothalamus & Pituitary

Rationale. The hypothalamus and pituitary orchestrate both the HPT (thyroid) and HPA (adrenal) axes. Thyroid disorders frequently co-present with anxiety/depression, while adrenal-axis dysregulation tracks with chronic stress. Acupuncture influences central networks (limbic system and hypothalamus) and can modulate neuroendocrine axes, providing a pathway to regulate both systems. [57–60]

Reviews and mechanistic studies report that acupuncture modulates HPA activity (including ACTH/cortisol) and exerts two-way regulation on HPT-related hormones; brain-imaging shows modulation of limbic/subcortical regions and hypothalamus. Clinical and experimental data suggest acupuncture may ease stress hyper-arousal and improve mood, aligning with thyroid and adrenal symptom relief. [57–62, 65–66]

In neurological care, the XNKQ method has demonstrated central regulatory effects in healthy volunteers and stroke patients, including changes in brain oscillations; its core points (DU26, PC6, SP6) are combined with individualized add-ons (e.g., GV20, ST36, LR3) to calm the Shen, soothe Liver-Qi, and support Spleen and Kidney. We adapt XNKQ principles to endocrine cases to ‘awaken the brain’ and normalize hypothalamic set-points for HPT/HPA balance. [63–64]

At EMC. For thyroid and adrenal patterns, we apply a central–peripheral strategy: (1) central regulation (XNKQ core + calming-Shen/Yin-anchoring points); (2) peripheral support (local neck micro-circulation points; body points to warm Kidney and Spleen or clear Heat/resolve Phlegm as indicated). Treatment is individualized; we coordinate with existing care and monitor symptoms, sleep, mood, and when appropriate thyroid indices. [18, 57–62]

Diet & Lifestyle in TCM framing

  • Warm, easy-to-digest meals to support Spleen Qi; adequate protein; avoid dampness-forming foods if phlegm is prominent.
  • Stress hygiene (breath, gentle movement, consistent sleep) to protect Kidney Essence and smooth Liver Qi practical, evidence-aligned steps given the high stress burden. [9, 10]

Our Herbal Support Blends

Thyroid Support (clinic formula)

Designed for low-thyroid presentations within a TCM pattern framework. Focus: promote microcirculation to the neck region, warm and tonify Kidney and Spleen, transform phlegm where needed, and harmonize Liver Qi. (We tailor dosing/adjunct herbs based on each patient’s pattern and labs.) [Clinic product description supplied by EMC]

  • Helps stimulate blood flow
  • Helps detox lymphatic system
  • Helps improve metabolism
  • Promotes happiness, energy & mental clarity

Built around adaptogenic “Qi-tonics” that help the body maintain equilibrium under stress, while anchoring Yin and calming the Shen. Modern reviews describe adaptogens such as Rhodiola, Eleutherococcus, and Schisandra as modulators of the HPA axis and stress resilience. [Clinic product description supplied by EMC] [19–21]

Note: We do not replace hormone therapy when medically indicated. Our approach targets the root (pattern correction) and the branch (symptoms) and often coordinates with your existing care.

Supports healthy adrenal function

  • Promotes vitality & stamina
  • Helps ease fatigue*
  • Supports healthy hormone production
  • Promotes healthy metabolism

References

  1. American Thyroid Association. “ATA Thyroid Brochure/Stats.” Accessed 2025.
  2. Wyne KL, et al. Hypothyroidism Prevalence in the United States. 2022.
  3. Hollowell JG, et al. J Clin Endocrinol Metab. 2002; 87:489–499 (NHANES III).
  4. Shaka H, et al. Endocr Pract. 2022. (Hyperthyroidism prevalence 1.2–1.3%).
  5. Zhang X, et al. Endocr Pract. 2023. (Trends in thyroid disease 1999–2018).
  6. Rushworth RL, Torpy DJ. Front Endocrinol. 2023. (Changing epidemiology of adrenal insufficiency).
  7. Munir S, et al. StatPearls: Addison Disease. Updated 2024. (Incidence/prevalence ranges).
  8. Wolff ASB, et al. Front Endocrinol. 2023. (Autoimmune primary adrenal insufficiency overview).
  9. APA. Stress in America 2024. Full report. Oct 2024.
  10. Gallup. Americans Sleeping Less, More Stressed. Apr 2024.
  11. Re RN, et al. J Clin Endocrinol Metab. 1976. (Dexamethasone suppresses TSH; metyrapone raises TSH).
  12. Fliers E, et al. An update on non-thyroidal illness syndrome. 2020. (Glucocorticoids & low T3 pattern).
  13. Endotext. Non-Thyroidal Illness Syndrome. (NTIS mechanism: ↓T3, ↑rT3, ±↓TSH).
  14. Yu P, et al. BMC Endocr Disord. 2024. (Thyroid function spectrum in Cushing’s).
  15. Cheng C-Y, et al. Tzu Chi Med J. 2024. (TCM for benign thyroid nodules).
  16. Chen F, et al. Evid-Based Complement Alternat Med. 2021. (Hai Zao Yu Hu Tang antigoiter effects preclinical).
  17. Huang S, et al. Antioxidants. 2024. (TCM for Hashimoto’s mechanisms review).
  18. Wang X, et al. Medicine (Baltimore). 2024. (Acupuncture for HT systematic review & meta-analysis).
  19. Tóth-Mészáros A, et al. Phytomedicine Plus. 2023. (Systematic review: adaptogens & stress).
  20. Liao L, et al. Chin Med. 2018. (Overview of adaptogens in TCM).
  21. Todorova V, et al. Appl Sci. 2021. (Adaptogens—history & mechanisms).
  22. Chen J, et al. Application of proteomics and metabonomics to reveal the molecular basis of Atractylodis macrocephalae rhizome for ameliorating hypothyroidism instead of hyperthyroidism. Front Pharmacol. 2021; 12:664319.
  23. Dharmananda S. Treatments for Thyroid Diseases with Chinese Herbal Medicine. Portland, OR: Institute for Traditional Medicine (ITM); 1996. (Monograph/online article; month not specified.)
  24. Sun W, et al. Immune-enhancing activity of polysaccharides isolated from Atractylodis macrocephalae Koidz. Carbohydr Polym. 2015; 126:91–96.
  25. Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018;24(3):243–248. doi:10.1089/acm.2017.0183.
  26. Zhang W, et al. Emerging therapeutic role of Prunella vulgaris in thyroid disease. Chinese Herbal Medicines. 2022.
  27. Sacred Lotus Chinese Medicine. Xia Ku Cao (Prunella, Selfheal) – herb monograph. (Web resource.)
  28. Liu L, et al. Towards a better understanding of medicinal uses of the brown seaweed Sargassum in Traditional Chinese Medicine: a phytochemical and pharmacological review. J Ethnopharmacol. 2012;142(3):591–619.
  29. Ma Y, et al. UPLC-TQ/MS determination of eleven bioactive components in Haizao Yuhu Decoction ± Haizao–Gancao combination after oral administration in a rat model of hypothyroidism. Molecules. 2016;22(1):7.
  30. Dwiranti F, et al. Effects of gametophytes of Ecklonia kurome on glucose and triacylglycerol levels in db/db prediabetic model. 2012. (Study details not fully specified in source.)
  31. Kalman DS, et al. Effect of a proprietary Magnolia and Phellodendron extract on stress levels in healthy women: a pilot, double-blind, placebo-controlled clinical trial. Nutr J. 2008; 7:11.
  32. Journal of Ethnopharmacology – journal homepage (ScienceDirect link).
  33. Lee HJ, Kim HL, Lee DR, Choi BK, Yang SH. Scrophulariae Radix: overview of biological activities and nutraceutical/pharmaceutical applications. Molecules. 2021;26(17):5250.
  34. MedicalNewsToday. ‘Herbs that improve thyroid health’. (Web article; non–peer reviewed).

 

Additional References — Adrenal Support (Adaptogens & Detox Blend)

  1. Provino R. The role of adaptogens in stress management. Aust J Med Herbal. 2010.
  2. WebMD. Rehmannia — uses, evidence, safety. (Web resource.)
  3. Bone K, Mills S. Herbal approaches to pathological states. In: Principles and Practice of Phytotherapy. 2nd ed. Churchill Livingstone; 2014:140–182. (Accessed 11 Jan 2021).
  4. Li B. Effects of triterpenoid from Schisandra chinensis on oxidative stress in alcohol‑induced liver injury in rats. Cell Biochem Biophys. 2015;71:803–811.
  5. Kalani A, Bahtiyar G, Sacerdote A. Ashwagandha root in the treatment of non‑classical adrenal hyperplasia. BMJ Case Rep. 2012;2012:bcr2012006989.
  6. Journal of Restorative Medicine. 2012;1(1):76–82. (Article details not fully specified in source provided.)
  7. Zhang W, et al. Astragalus membranaceus ultrafine powder alleviates hyperuricemia by regulating the gut microbiome and reversing bile acid and adrenal hormone biosynthesis dysregulation. Arabian J Chem. 2022:103970.
  8. Altınterim B. Effects of herbs on hypothalamic‑pituitary‑gonadal (HPG) axis and hypothalamic‑pituitary‑adrenal (HPA) axis. ACU Sağlık Bil Derg. 2014;3:179–181.
  9. Kraemer WJ, et al. Cortitrol supplementation reduces serum cortisol responses to physical stress. Metabolism. 2005;54(5):657–668.
  10. Yao R, et al. Effects of Epimedium flavonoids on proliferation and differentiation of neural stem cells in vitro. Neurol Res. 2010;32(7):736–742.
  11. Winston D. Adaptogens: Herbs for Strength, Stamina, and Stress Relief. New York: Simon & Schuster; 2019.
  12. Panossian AG. Adaptogens: tonic herbs for fatigue and stress. Altern Complement Ther. 2003;9(6):327–331.
  13. DrLam Coaching. Detoxification overview. (Web article; informational).
  14. Dinan TG, Cryan JF. Brain‑gut‑microbiota axis and mental health. Psychosom Med. 2017;79(8):920–926. (DOI not provided in source.)
  15. Tan J, Qi H, Ni J. Extracts of endophytic fungus xkc‑s03 from Prunella vulgaris L. spica inhibit gastric cancer in vitro and in vivo. Oncol Lett. 2015;9(2):945–949.
  16. Sacred Lotus Chinese Medicine. Yu Mi Xu (Corn Silk) — herb monograph. (Web resource.)
  17. Ha AW, et al. Acute and subacute toxicity evaluation of corn silk extract. Prev Nutr Food Sci. 2018;23(1):70–76.
  18. Pfingstgraf IO, et al. Protective effects of Taraxacum officinale (dandelion) root extract in experimental acute‑on‑chronic liver failure. Antioxidants. 2021;10(4):504.
  19. Fuchs SM, et al. Assessment of anti‑inflammatory activity of Poria cocos in sodium lauryl sulphate‑induced irritant contact dermatitis. Skin Res Technol. 2006;12(4):223–227.
  20. Liu X, et al. Protective effects of Poria cocos‑derived polysaccharide CMP33 against IBD in mice and its molecular mechanism. Food Funct. 2018;9(11):5936–5949.
  21. Gu C, Yang X, Huang L. Cistanches Herba: a neuropharmacology review. Front Pharmacol. 2016;7:289.
  22. Li Z, Lin H, Gu L, Gao J, Tzeng CM. Herba Cistanche (Rou Cong‑Rong): one of the best pharmaceutical gifts of Traditional Chinese Medicine. Front Pharmacol. 2016;7:41.

New References for Neuroendocrine/Acupuncture Section (57–66)Zheng JY, Zhu J, Wang Y, Tian ZZ. Effects of acupuncture on hypothalamic–pituitary–adrenal axis: current status and future perspectives. J Integr Med. 2024;22(4):446–459.

  1. Ding SS, et al. Acupuncture modulates the neuro–endocrine–immune network. QJM. 2014;107(5):341–345.
  2. Hui KKS, et al. Acupuncture modulates the limbic system and subcortical gray structures: fMRI evidence. Hum Brain Mapp. 2000;9(1):13–25.
  3. Huang W, et al. Characterizing acupuncture stimuli using brain imaging with fMRI. PLoS One. 2012;7(4):e32960.
  4. Liu C, et al. Effects of acupuncture on the hypothalamus–pituitary–target gland axes: a review. Evid Based Complement Alternat Med. 2019;2019:Article 1–15.
  5. Cui J, et al. Research progress on the mechanism of the acupuncture regulating of endocrine system. Evid Based Complement Alternat Med. 2021;2021:Article 1–12.
  6. Nierhaus T, et al. Somatosensory stimulation with Xingnao Kaiqiao (XNKQ) acupuncture modulates brain activity in healthy adults. Front Neurosci. 2019;13:147.
  7. Guo X, et al. Modulation of brain rhythm oscillations by Xingnao Kaiqiao acupuncture and correlation with stroke recovery. J Altern Complement Med. 2022;28(10):1041–1051.
  8. Sun B, et al. Treatment of depression with acupuncture based on HPA axis: evidence synthesis. Chin Med. 2024;19:Article.
  9. Eshkevari L, et al. Effects of electroacupuncture on HPA activity in a stress model; RU-486 experiments. Endocrinology. 2015;156(10):3649–3660.